1. Leadership Middle Tennessee Medical Center Tracey L. Pavelchik

2. Preceptorship Middle Tennessee Medical Center Surgical Services Roberta Rogers- Director of Surgical Services Gay Ensey- Nurse Manager PACU

3. Tale of Two Preceptors Roberta Rogers, Director of Surgical Services- original preceptor – Due to vacations and scheduling, I was delegated to a new preceptor after one week. Gay Ensey, Nurse Manager PACU- secondary preceptor. – Gay has been an preceptor at MTMC before and was excited to have a student. Most of my time was spent with Gay.

5. Management Style Transformational Leadership – Enthusiastic – Seeks input from others – Acts as a mentor and coach – Values her staff – Uses personal touches “Thank you” “How is your family?”

6. Management Style It is obvious Gay is well loved by her staff and those throughout the hospital. She was always the first one to jump in if the staff needed help, but stayed out of their way and empowered them to work individually and as a team. Gay asked others opinions before making decisions that would affect the whole department, but could also make the hard decisions without input when necessary.

7. Leadership Project Objectives – Assess productivity trends in the PACU. – Develop a method to involve staff in tracking and following productivity standards. – Educate the staff in PACU as to how productivity standards are calculated. – Involve staff in reaching productivity goals.

9. Leadership Project Developed a bar graph chart to track daily productivity goals. Developed an informational flyer to explain productivity and its calculations. These were displayed in the staff break room on their information bulletin board.

10. PACU PRODUCTIVITY Current Productivity Goal 2.6 Staffed Hours Per Patient Hour You have heard all about that magical 2.6 number, so just What does it all mean? On a typical 17-hour PACU day we average 90-100 scheduled staffing hours. In order to meet productivity we need 37 billable patient hours. (Excluding weekends) EXAMPLE: 37 patient hours x 2.6 staffing hours= 96.2 scheduled hours July’s Productivity: 2.40 August’s Productivity: 2.33 September’s Productivity: Great Job! Keep up the Good Work!

11. Preceptor Experience Since I was assigned to the Surgical Services department, I was lucky enough to be able to travel all over the hospital and really get a feel for every department involved in Surgical Services. – Operating room- Scrub nurse, Assistant, Circulator, Anesthesia – Same Day, Holding, PACU, Labor and Delivery, Diagnostics

12. Typical Operating Room

13. Following the Patient Patient checks in with Same Day Surgery Nuclear Medicine for Sentinel Node Back to Same Day Pre-Op/ Holding Surgery- Mastectomy of Right Breast PACU To Patient’s room

14. Inside the Operating Room

15. Following the Patient Most Impressed with the communication hand off. – Patient History – Checking Patient Identification – Allergies – What are you having done today?

16. Strengths and Weaknesses of the Organization Strengths – Excellent Teamwork and Patient Coordination – Communication/ Patient Handoff – Effectiveness of the Department Organization – Competency and Caring of the Staff

17. Strengths and Weaknesses of the Organization Weaknesses – Older Hospital – Paper Charting within Surgical Services – React to problems rather than predicting problems. – Business as usual

18. Recommendations Lessen the frequency of meetings; involve technology more. Rounding with purpose to see problems before they happen. Many current problems are being addressed. – New hospital under construction. – Computer charting being implemented.

19. Specific Clinical Issue Communication with families of loved ones having surgery seems to be “hit and miss.” Volunteer services staffs the surgical waiting room. Families often go eat or take smoke breaks during surgery and miss calls from staff. How do we decrease family anxiety?

20. PICO Question Among the family members and loved ones of patients undergoing surgical procedures, is communication enhanced by providing pagers or beepers to the family members?